Lookout Stages Rally 2019 Internet Entry Form

Final closing date for entries is Tuesday 2nd April 2019 - Midday

 

Entries Secretaries: John & Gill Williams
The Old Chapel
Main Street
Oldstead
York
YO61 4BL

Telephone:01347 868016

E-Mail: lookoutentries@theturnbulls.co.uk

Held under the General Regulations of Motorsport UK (incorporating the International Sporting Code of the FIA) and the Supplementary Regulations

Welcome to the Trackrod Lookout Stages Rally 2019 Online Entry system. Please follow the steps below to enter the rally.

  1. Complete all the fields in the form below. The fields with red backgrounds are mandatory.
  2. Once you have hit the "Enter the Rally" button at the end you will receive an automated response confirming we have received your entry form.
  3. There are then three ways to pay
    1. You can send a cheque, made payable to 'Trackrod Lookout Rally' to the Entries Secretaries at the address above.All cheques to be received by Friday 29th March 2019. Please include drivers name on back of Cheque
    2. Card payment byStripe
    3. By Bank Transfer to account 'Lookout Stages Rally' Sort Code 05-00-40 Account No 10105968, please include drivers name as reference
  4. Within 24 hours of us receiving the payment for your entry you should receive an e-mail confirming your entry from the Entries Secretary. NOTE: WITHOUT PAYMENT YOUR ENTRY WILL NOT BE VALID.
  5. If you don't receive a response within 3 days of the expected payment date, or if you have any other questions, please e-mail lookoutentries@theturnbulls.co.uk

 

Document Addressing
E-Mail address for communication and finals/results
Real Name of this person
Driver
Full Name
Address
Post Code
Telephone Number
Mobile Number
Competition Licence Number
E-Mail Address
Club
Date of Birth (if under 18 years of age)
Driver Publicity
How Long Rallying?
Notable Results
Any other information
Driver's Parent or Guardian (under 18 only)
Name
Address (if different)
Post Code
Telephone Number
Relationship
Co-Driver
Full Name
Address
Post Code
Telephone Number
Mobile Number
Competition Licence Number
E-Mail Address
Club
Date of Birth (if under 18 years of age)
Co-Driver Publicity
How Long Rallying?
Notable Results
Any other information
Co-Driver's Parent or Guardian (under 18 only)
Name
Address (if different)
Post Code
Telephone Number
Relationship
Car Details
Make
Model
Colour
Registration Number
Engine Capacity
Year
Forced Induction
Four Wheel Drive
Class
Sponsor
Sponsor Name (Note: this sponsor does not need an entrant's licence.
If you have an entrant with an entrant's licence,
please give details later.
Championships
EMAMC
Crew Members Registered
ANCC
Crew Members Registered
ANWCC
Crew Members Registered
Eligible for Lady Driver Award
Crew Members Registered
Eligible for Mixed Crew Award
Crew Members Registered
Eligible for Trackrod Crew Award
Crew Members Registered
BIMMA Cup
Crew Members Registered
Person to be contacted in case of serious accident to Driver
Name
Address
Post Code
Telephone Number
Relationship
Will this person be attending the event?
Person to be contacted in case of serious accident to Co-Driver
Name
Address
Post Code
Telephone Number
Relationship
Will this person be attending the event?
Seeding - Past Performance on Rallies
Event Name and ClubYearTypeSurfaceOverall PositionNo of Starters
Seeding - Competitor Opinion
Out of 50 entries, where do you think you should be seeded?
Scrutineering
When would you prefer to scrutineer and sign on? Saturday 16.30 to 18.30
Sunday 06.30 to 08.00
Fees - see above for how to pay
Entry Fee £
Club Membership £
Total Money to be sent£
Payment Method and Details
Entrant (if applicable and not driver) No entry will be credited to an Entrant unless the Licence Number is quoted here.  This licence MUST be produced at signing on.
Name
Address
Post Code
Telephone Number
Nationality
Competition Licence Number
Competition Licence Issuer
Privacy and Permissions

We take your privacy seriously and will only use your personal information to administer your entry, including providing a public Entry List and sending you emails in connection with your entry. Some of your information will be passed on to the organisation providing results for the event.

We would also like to be allowed to contact you in the future to tell you about other events which we are running, including this event in future years. If you are happy to allow us to do this, please say so here.

We would also like to be allowed to pass on your Name, Address, Post Code and email addresses to [MAD Video] so that they can contact you with a view to offering you videos and photos of you on the event. If you are happy to allow us to do this, please say so here.

Declaration of Indemnity

 

I declare that:

1. I have been given an opportunity to read the General Regulations of  Motorsport UK and, if any, the
Supplementary Regulations for this event and agree to be bound by them. I declare that I am physically and mentally fit
to take part in the event and I am competent to do so. I acknowledge that I understand the nature and type of the
competition and the potential risk inherent with motor sport and agree to accept that risk.


2 To the best of my belief the driver(s) possess(es) the standard of competence necessary for an event of the type to which
this entry relates and that the vehicle entered is suitable and roadworthy for the event having regard to the course and the
speeds which will be reached.


3. I understand that should I at the time of this event be suffering from any disability whether permanent or temporary
which is likely to affect prejudicially my normal control of the vehicle, I may not take part unless I have declared such
disability to the ASN who have, following such declaration, issued a licence which permits me to do so.

4. Any application form for a licence which was signed by a person under the age of 18 years was countersigned by
that person’s parent/guardian/guarantor, whose names and addresses have been given.

5. If I am the parent/guardian/guarantor of the driver “I understand that I shall have the right to be present during any
procedure being carried out under the Supplementary Regulations issued for this event and the General Regulations of
Motorsport UK. As the Parent/Guarantor “I can confirm that I have acquainted myself with the Motorsport UK General Regulations,
agree to pay any appropriate charges and fees pursuant to those Regulations (to include any appendices thereto) and
hereby agree to be bound by those Regulations and submit myself without reserve to the consequences resulting from
those Regulations (and any subsequent alteration thereof). Further, I agree to pay as liquidated damages any fines
imposed upon me up to the maxima set out in Motorsport UK General Regulations Part 3, Appendix 3”

Note: Where the parent/guardian/guarantor of the driver is not present there must be a representative who must
produce a written and signed authorisation to so act from the parent/guardian/guarantor as appropriate.


6. I hereby agree to abide by the Motorsport UK Child Protection Policy and Guidelines.

7. I undertake that at the time of the event to which this entry relates I shall have passed or am exempt from an ASN
specified medical examination within the specified period.

 

Web Entries System provided by rallies.info